Filing Details

Accession Number:
0001104659-10-003866
Form Type:
4
Zero Holdings:
No
Publication Time:
2010-01-29 12:00:00
Reporting Period:
2010-01-25
Filing Date:
2010-01-29
Accepted Time:
2010-01-29 13:23:09
SEC Url:
Form 4 Filing
Issuer
Cik Name Symbol Sector (SIC) IRS No
1045739 Etelos Inc. ETLO Services-Prepackaged Software (7372) 770407364
Insiders
Cik Name Reported Address Insider Title Director Officer Large Shareholder Other
1434703 W. Donald Morissette 4230 Galewood
Suite 100
Lake Oswego OR 97035
No No Yes No
Reported Non-Derivative Transactions
Sec. Name Acquisiton - Disposition Date Amount Price Remaning Holdings Equity Swap Involved Form Type Code Nature of Ownership Explanation
Common Stock Acquisiton 2010-01-25 375,000 $0.00 9,728,650 No 4 P Indirect Don Morissette LLC
Equity Swap Involved Form Type Code Nature of Ownership Explanation
No 4 P Indirect Don Morissette LLC
Reported Derivative Transactions
Sec. Name Sec. Type Acquisiton - Disposition Date Amount Price Amount - 2 Price - 2
Common Stock 10% Convertible Debentures Acquisiton 2010-01-25 0 $0.00 500,000 $0.50
Common Stock Common Stock Warrant (Right to Buy) Acquisiton 2010-01-25 375,000 $0.00 375,000 $0.60
Remaning Holdings Exercise Date Expiration Date Equity Swap Involved Transaction Form Type Transaction Code Nature of Ownership
0 2010-01-25 No 4 P Indirect
375,000 2010-01-25 2014-09-30 No 4 P Indirect
Footnotes
  1. Don Morissette LLC is wholly owned by the Reporting Person.
  2. The 10% Convertible Debenture is convertible at any time to Common Stock at $0.50 per share, and expires upon repayment and maturity date September 30, 2011.
  3. The reported securities are included within securities purchased by the reporting person. The securities consist of: (i) 10% convertible debenture in the principal amount of $250,000, (ii) warrant to purchase 375,000 shares of common stock; and, (iii) 375,000 shares of common stock.